Provider Demographics
NPI:1528308780
Name:POOLE, SOOJIN H (LMFT)
Entity type:Individual
Prefix:
First Name:SOOJIN
Middle Name:H
Last Name:POOLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:S
Other - Last Name:FALKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:438 CAMINO DEL RIO S STE 112
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3546
Mailing Address - Country:US
Mailing Address - Phone:619-787-6676
Mailing Address - Fax:619-516-3594
Practice Address - Street 1:438 CAMINO DEL RIO S STE 112
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3546
Practice Address - Country:US
Practice Address - Phone:619-787-6676
Practice Address - Fax:619-516-3594
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT97800106H00000X
CAIMF78694101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist